12导联ECG到心内向量转换的可视化研究

1星需积分: 10 152 浏览量更新于2024-09-07 1 收藏 1.26MB PDF 举报

"这篇论文探讨了心电图12导联与心内向量转换的关系，特别是关于通过视觉转换技术从传统12导联心电图中估算空间QRS-T角度的准确性。研究背景是12导联心电图导出的空间QRS-T角度在预测和诊断心脏疾病中有重要价值，但大多数ECG设备并未报告这一指标。主要目标是确定是否存在快速的视觉估计方法，以从常规12导联心电图记录中准确地估算出空间QRS-T角度的峰值。方法与结果：研究人员从一个公开数据库获取了100名心肌梗死后患者的同步12导联和Frank XYZ导联记录，以及50名对照组的数据。他们运用方差分析（ANOVA）、皮尔逊相关系数和一致性图来评估真实Frank导联与从12导联心电图推算出的空间QRS-T角度峰值之间的同意程度。这些统计方法旨在评估转换的可靠性和有效性。论文作者包括来自不同医疗机构和机构的专家，如CHOC Children's、Children's Hospital of Colorado、Cleveland Clinic Foundation、Indiana Wesleyan University以及NASA Johnson Space Center的医生和博士。这表明该研究涉及多学科合作，并可能考虑了心电图技术在儿科、心脏病学、航空航天医学等多个领域的应用。结论：通过这项研究，作者可能揭示了使用现有心电图设备进行心内向量分析的潜在新方法，这些方法可能提高临床医生在没有专用Frank导联系统的情况下评估患者心脏健康状况的能力。如果这种方法被证明是可靠的，它将简化心电图分析，促进更广泛的应用，并可能对心脏疾病的早期检测和管理产生积极影响。" 这篇论文的核心内容围绕着如何利用现有的12导联心电图数据，通过视觉转换技术来估算与Frank导联系统相当的心内向量信息。这对于心脏病的诊断和预后评估具有重要意义，尤其是当医疗资源有限或无法立即获取复杂心电监测设备时。通过提高这种估算的准确性，可以增强临床决策支持，并可能为远程医疗和便携式心电监测设备的发展提供新的途径。

Visual transform applications for estimating the spatial QRS –T angle

from the conventional 12-lead ECG: Kors is still most Frank

Daniel Cortez, MD,

a, b,

⁎

Nandita Sharma, MD,

Christopher Devers, PhD,

Erin Devers, PhD,

Todd T. Schlegel, MD

CHOC Children's, Orange, CA, USA

Children's Hospital of Colorado, Aurora, CA, USA

Cleveland Clinic Foundation, Cleveland, OH, USA

Indiana Wesleyan University, Marion, IN, USA

NASA Johnson Space Center, Houston, TX, USA

Abstract Background: The 12-lead ECG-derived spatial QRS–T angle has prognostic and diagnostic utility,

but most ECG machines currently fail to report it. The primary goal was to determine if reasonably

accurate methods exist for rapid visual estimations of the spatial peaks QRS–T angle from

conventional 12-lead ECG tracings.

Methods and Results: Simultaneous 12-lead and Frank XYZ-lead recordings were obtained from a

publicly available database for 100 post-myocardial infarction patients and 50 controls. ANOVA,

Pearson's correlation coefficients and concordance plots were used to evaluate agreement for spatial

peaks QRS–T angle results from the true Frank leads versus from several visually applied 12-to-

Frank XYZ-lead transforms. The latter included Kors et al.'s regression and quasi-orthogonal, Bjerle

and Arvedson's quasi-orthogonal, Dower's inverse, and Hyttinen et al.'s, Dawson et al.'s and

Guillem et al.'s transforms. Spatial peaks QRS–T angles derived from the true Frank leads were not

statistically significantly different from those derived from any visually applied transform. Of the

visually applied transforms, the Kors' regression and Kors' quasi-orthogonal yielded the highest

Pearson correlation coefficients against the gold-standard true Frank lead results [0.84 and 0.77,

respectively, when individuals with bundle branch blocks were included (N = 150), and 0.88 and

0.80, respectively, when individuals with bundle branch blocks were excluded (N = 137)]. Bland–

Altman 95% confidence intervals showed similar results, with the two Kors'-related methods also

having the narrowest confidence intervals.

Conclusions: When visually applied, the Kors' regression-related and quasi-orthogonal transforms

allow for reasonably precise spatial peaks QRS–T estimates and thus a potentially practical way to

visually estimate spatial peaks QRS–T angles from conventional 12-lead ECGs.

Keywords: Reconstruction; Transform; Vectorcardiography; Frank; Orthogonal

Introduction

The spatial QRS –T angle is a vectorcardiographic (VCG)

parameter with notable diagno stic [1–5] and prognostic

[2,6–15] utility. For example in a recent study by Borleffs et

al. [6] of 412 patients who had coronary ischemia as well as

implanted cardiac defibrillators (ICD's) and ejection frac-

tions ≤ 40%, a spatial angle greater than 100 degrees was

associated with a hazard ratio for appropriate ICD discharge

of 7.3. In addition to assisting with risk stratification for

cardiac events, the angle is also useful for evaluation of

incident coronary heart disease [2,4,12], heart failure

[4,11,13], and the efficacy of therapy for adult hypertension

[1] and diabetes mellitus [5]. Most recently the spatial QRS–

T angle has also been shown to be more useful than any

parameter from the conventional scalar 12-lead ECG for

identifying both adult and pediatric hypertrophic cardiomy-

opathy [3,16]. As noted in previous publications, of the

various methods used for deriving the Frank XYZ leads

from conventional 12-lead ECG recordings, and then in turn

for estimating secondary parameters such as the spatial

QRS–T angle, the regression method described by Kors

Available online at www.sciencedirect.com

ScienceDirect

Journal of Electrocardiology 47 (2014) 12 – 19

www.jecgonline.com

⁎

Corresponding author. CHOC Children's/Children's Hospi tal of

Colorado, 455 South Main Street, Orange, CA 92868, USA.

E-mail address: dr.danielcortez@gmail.com

http://dx.doi.org/10.1016/j.jelectrocard.2013.09.003

下载后可阅读完整内容，剩余7页未读，立即下载

weixin_43717020

粉丝: 0

12导联ECG到心内向量转换的可视化研究

心电图导联线及移动式操作平台应用指南

256导联心电图特征分析与噪声消除研究

高效分析12导联心电图数据的关键工具

心电图导联及心电轴.doc

ECG Workstation V3.4.1心电图（ECG）数据3导联 12导联 18导联心电图数据

12导联动态心电远程监测系统的设计与实现_毕业设计_论文.pdf

电子-一种新型心电图导联电极

心电图导联位置之欧阳治创编.pdf

电子政务-儿童心电图导联线电极.zip

心电图导联连接快速确定位置及图示.pdf

最新资源